2026-04-09 LabMCoP Meeting Notes

Date

Apr 9, 2026

Attendees

Present	Name	Organization
X	Nancy Cornish	CDC
X	Manjula Dharmawardhana	CDC
X	Riki Merrick	APHL
-	Christina Gallegos	APHL
X	Amy Liu	Inductive Health / APHL
	Raj Dash	Duke / CAP
X	John Snyder	Pragmatic Terminologies, LLC
X	Andrea Pitkus	UW
X	Kathy Walsh	Labcorp
	Rob Hausam	Hausam Consulting
	Pam Banning	3M
	Elissa Passiment

Upcoming OOO		Reminder: We are now using https://aphlinformatics.atlassian.net/wiki/spaces/LMCOPL/calendars and everyone can just keep it updated NOTE: you will need to use type “Event” if you do not have a confluence account
Working with DHQP for NHSN reporting	Nancy	Scheduled for next week - Apr 16, 2026 Christina Betz and Diego will join
Specimen CMT - Hosting Options		Follow ups: Using FHIR to publish: Re-read If ConceptMap resource in FHIR R6 incorporated the coding datatype for valueset attributes - Riki to ask Marc Duteau if that Jira was submitted / applied for R6 and see if he could work with us on trying to create examples proposed FHIR conceptmap schema: Proposed by HL7 TI WG: create an implementation guide Ask THO to publish this as a “code system” to be hosted on the ONC FHIR terminology server? Ask Clinical Architecture if they can produce FHIR resource from CMT Publication behind NLMs UMLS license: There is a way for another organization to host a product like the specimen cross mapping table on a different server but still have it behind the UMLS license. Here is the information that I was given: There are two ways - they can authenticate using an API key, using this API: . This is the simplest way to do it. Alternatively, they can set up authentication on a website using a web browser (via ). This requires some extra steps - we would need to whitelist any web domains they are using. If they are interested in this option, we can provide further instructions. Again, the API key option is the easiest to implement. If we identify a group, whether it is symmedical or CDC, that wants to host the database that Manjula created we can still go down that path and have it behind the UMLS license. This would cover us from a US perspective. Update on I will let you know what I find out about NLM hosting the flat files (would like to have this as tab-delimited files rather than csv - need to figure out how to deal with the special text characters) for download. NLM does not have resource to host the dB, could find out if they know who could host Have Snomed International host files to download Requirements for hosting sites: need to be freely accessible (no cost), though licensing for the SCT concept is still required (for US use its ok) need human readable access need access for machines (API) direct download Get input from EHR-s and LIS vendors about best format to share: Professional organizations - like CAP and ACOS and AJCC get them to write the synoptic reports (better structuring of data) - for surgical aspects - similar to what CAP has done for Cancer, AMA support to get providers to adopt this Reach out to IDSA, too
Specimen CMT terms	Christina	Not this week
ONC restructuring	Nancy	Follow up on impact of removing ASTP from ONC - ask Sara on SHIELD
CMT Governance process		Current situation: data is in smartsheet, on an APHL hosted dB (postGress backend with Manjula’s SQL based front end) and APHL’s instance of Clinical Architecture (with adaptive workflow) - need to decide what the source of truth should be Clinical Architecture licensing questions - Riki to follow up goal is to have the “columns” be less V2 specific ONC is creating tooling to support HL7 implementations - maybe ask Carmela, if ONC can host some SHIELD folks (Deloitte) are still working on the LIDR tooling - now referred to as the decide extension in KOMET ( ), they were surprised that FHIR is not supported in labs
CMT proposed maintenance process		Who can make decisions? What is the process for change requests? Would be good to have a ticketing system for change requests (depends who is actually “owning” the data maintenance process Does this include review by professional organizations for the respective domains? for row changes can append the offical version ID with something (using table triggers), should be able to identify those need to decide if we track major and minor changes - introduces more complexity (didn’t work that well in LOINC) - decide each release is major, provide a change log (need to decide to what detail to include) and include a change reason and consider impact Create delta file and full version? Start writing this up on this confluence page: What timeframe / frequency for releases? SCT updates occur in March and September - suggest Dec and July releases, so we have 3 month to make any resulting changes from that and include any new content that is ready at that release date consider using date for versionID to match SCT To the question of a uesr guide: we have started this page: - let’s use this page to build that out
Follow up items	not today	Riki’s Follow up - none of these got done yet Contact United Network for Organ Sharing for input on donor terms (pre-coordinated or not?) = ISBT 128 \| ICCBBA \| Technical Documents https://www.isbt128.org/_files/ugd/1a7593_edfd176861c94dca94c34eff8fa3ad0d.pdf - for organs Riki has some contact now with European bloodbank and biobanks = Home - BBMRI-ERIC working with the folks that define their minimum data set: MIABIS - BBMRI-ERIC - these folks shared the follwoing for the reject reason topic, but it seems they differentiate between source site and the organ: #1 Standard PREanalytical Code Version 4.0 - (version 3.0 is here: https://cdn.ymaws.com/www.isber.org/resource/resmgr/isber_2019/pdf/standard_preanalytical_code_.pdf) and also Robin for US Clinical Archtecture unmapped LOINCs: Riki should check up with Charlie to see, if he knows where the LOINCs using the shorname in the description come from - as that is discouraged Riki to set up her VSAC authoring log in For wound modeling (see 2023-11-30 LabMCoP Meeting Notes ) create a few pre-coordinated specimen terms to cover the wound causes as children under: 119365002 \| Specimen from wound (specimen) another child term for aspirate under 445611000124106 \| Specimen from bite wound (specimen), since that is preferred over the existing swab
Lab tests as procedures or orderables	Do we still need this?	Recommendation by SNOMED is that the Observable entity hierarchy be used for both ordering and resulting. As for the technique hierarchy, that in no way is intended to be used for either ordering or resulting laboratory tests. Those concepts are used to model both observables and procedures. SNOMED LOINC extension: The problem is that major EHR-s vendors have set up CPOE using Procedures for orders to initiate a workflow (that creates the triggering event in the system) - that’s where the push-back comes from. There is a CPT to SNOMED CT mapping (as a paid mapping available from AMA), but no LOINC mapping. Can we reach out to CAP Informatics, ADLM Informatics and ASCLS Informatics to get their take on where Lab tests should live We had said we would work through the Colonoscopy example: Reference links: clinical guidelines: Official journal of the American College of Gastroenterology \| ACG Quality Indicators: Official journal of the American College of Gastroenterology \| ACG For CAP cancer reporting is using SNOMED CT - would be good to look which they chose to represent the performed lab test There is this question in the LOINC Community: it is related to this US Core FHIR Change request: https://jira.hl7.org/browse/FHIR-54415 Answer to this one is that in USCDI Procedure (https://isp.healthit.gov/taxonomy/term/781/uscdi-v6) does not list LOINC as applicable Vocab standard in any verion, so remove it. Often folks think of lab tests as procedures, because they can be ordered in CPOE (and outsidde the US, in the UK for example that’s how folks have modeled those, which is why LOINC was adding more of the high level order codes in 2.81 release, so we still should tackle the LOINC community question. John was working on creatign an intesnional valueset definition based on class + type and maybe a few other attributes
European Semantic work	not today	Link to the German FHIR IG around suceptibility testing: Semantic Example section: Confluence page: Ask if Rob can keep us updated
Specimen CMT pilot implementers	not today	Review where we are: Vendor Connections
Specimen CMT - education	not today	Need education for providers and IT folks that helps with set up of the EHR-S / LIS configuration -this can be supported / accomplished? with the Implementaiton Guide we could write if we have a use case of how a patient is impacted on their journey through the healthcare system - CAP created a nice video that showed how patient care was affected by incorrect data
Specimen CMT - tracking implementation impact Setting baseline Define metrics	not today
Future projects for this call after CMT	not today	In general the call is intended as a forum for ANY messaging related issues to work out. In the past we have reviewed containers re-vive that - and how does that interact with devices (UDI identification?) review code systems around additives (HL70371 and SCT substance and product hierarchies) started work on cross-mapping between HL7 method codes and SNOMED CT procedure / technique concepts American College of Surgeons is working on procedure protocol and synoptic data elements / surgical synoptic reports - we could work with them together on that Look at other HL7 tables that we would want to migrate SCT

Recording:

If you are interested in the recording, please email riki.merrick@aphl.org

Chat:

11:16:06 From Andrea Pitkus : Also these details could be exchanged in messaging across different parts of workflow (eg orders, results reporting, ph)
11:24:58 From Andrea Pitkus : I presented to ASCLS national mtg a few years ago.
11:54:58 From Andrea Pitkus : If folks are not familiar, this is what we've been discussing:
12:00:41 From Andrea Pitkus : Is there a user guide describing terms, usage, details. we've been discussing?
12:02:23 From Manjula Dharmawardhana (CDC) : Reacted to "describing terms, us..." with 👍
12:04:00 From Andrea Pitkus : sacher torte

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